Posted 2004-12-13
Most people at their first consultation take a furtive look at the surgeon’s hands in the hope of reassurance. Prospective patients look for delicacy, sensitivity, steadiness, perhaps unblemished pallor. On this basis, Henry Perowne loses a number of cases each year. Generally, he knows it’s about to happen before the patient does: the downward glance repeated, the prepared questions beginning to falter, the overemphatic thanks during the retreat to the door. Other patients don’t like what they see but are ignorant of their right to go elsewhere; some note the hands but are placated by the reputation, or don’t give a damn; and there are still others who notice nothing, or feel nothing, or are unable to communicate owing to the cognitive impairment that has brought them in the first place.
Perowne himself is not concerned. Let the defectors go along the corridor or across town. Others will take their place. The sea of neural misery is wide and deep. These hands are steady enough, but they are large. Had he been a proper pianist—he’s dabbled inexpertly—his ten-note span might be of use. They are knobby hands, bulging with bone and sinew at the knuckles, with a thatch of gingerish hair at the base of each finger, the tips of which are flat and broad, like the suckers on a salamander. There’s an immodest length to the thumbs, which curve back, banana style, and even at rest have a double-jointed look, more suited to the circus ring, among the clowns and trapezists. And the hands, like much of the rest of Perowne, are gaily freckled in a motley of orange and brown melanin extending right up to his highest knuckles. To a certain kind of patient, this looks alien, even unwholesome: you might not want such hands, even gloved, tinkering with your brain.
This week, he was pushed hard by a flu outbreak among the hospital staff—his operating list was twice the usual length. By means of balancing and doubling, he was able to perform major surgery in one theatre, supervise a senior registrar in another, and perform minor procedures in a third. He has two neurosurgical registrars on his team at present—Sally Madden, who is almost qualified and entirely reliable, and a year-two registrar, Rodney Browne, from Guyana, gifted, hardworking, but still unsure of himself. Perowne’s consultant anesthetist, Jay Strauss, has his own registrar, Gita Syal. For three days, keeping Rodney at his side, Perowne moved between the three suites—the sound of his own clogs on the corridor’s polished floors and the various squeaks and groans of the theatre swing doors sounded like orchestral accompaniments.
Friday’s list was typical. While Sally closed up one patient, Perowne went next door to relieve an elderly lady of her trigeminal neuralgia, her tic douloureux. These minor operations can still give him pleasure—he likes to be fast and accurate. He slipped a gloved forefinger into the back of her mouth to feel the route, then, with barely a glance at the image intensifier, slid a long needle through the outside of her cheek, all the way up to the trigeminal ganglion. Jay came in from next door to watch Gita bringing the lady to brief consciousness. An electrical impulse at the needle’s tip caused a tingling in her face, and once she’d drowsily confirmed that the position was correct—Perowne had it right first time—she was put down again while the nerve was “cooked” by radiofrequency thermocoagulation. The delicate trick was to eliminate her pain while leaving her an awareness of light touch—all done in fifteen minutes, three years’ misery, of sharp, stabbing pain, ended.
He clipped the neck of a middle-cerebral-artery aneurysm—he’s something of a master in the art—and performed a biopsy for a tumor in the thalamus, a region where it’s not possible to operate. The patient was a twenty-eight-year-old professional tennis player, already suffering acute memory loss. As Perowne drew the needle clear of the depths of the brain, he could see at a glance that the tissue was abnormal. He held out little hope for radio- or chemotherapy. Confirmation came in a verbal report from the lab, and that afternoon he broke the news to the young man’s elderly parents.
The culmination of today’s list was the removal of a pilocytic astrocytoma from a fourteen-year-old Nigerian girl who lived in Brixton with her aunt and uncle, a Church of England vicar. The tumor was best reached through the back of the head, by an infratentorial supracerebellar route, with the anesthetized patient in a sitting position. This created special problems for Jay Strauss, for there was a possibility of air entering a vein and causing an embolism.
The Nigerian girl’s operation lasted five hours and went well. Andrea was placed in a sitting position. Opening up the back of the head needed great care because of the vessels running close under the bone. Rodney leaned in at Perowne’s side to irrigate the drilling and cauterize the bleeding with the bipolar. Finally it lay exposed, the tentorium—the tent—a pale delicate structure of beauty, like the little whirl of a veiled dancer, where the dura is gathered and parted again. Below it lay the cerebellum. By cutting away carefully, Perowne allowed gravity itself to draw the cerebellum down—no need for retractors—and it was possible to see deep into the region where the pineal lay, with the tumor extending in a vast red mass right in front of it. The astrocytoma was well defined and had only partially infiltrated surrounding tissue. Perowne was able to excise almost all of it without damaging any eloquent region.
He allowed Rodney several minutes with the microscope and the sucker, and let him do the closing up. Perowne did the head dressing himself, and when he finally came away from the theatres he wasn’t feeling tired at all. Operating never wearies him—once busy within the enclosed world of his team, the theatre and its ordered procedures, and absorbed by the vivid foreshortening of the operating microscope as he follows a corridor to a desired site, he experiences a superhuman capacity, more like a craving, for work.
As for the rest of the week, the two morning clinics made no more demand than usual. He’s too experienced to be touched by the varieties of distress he encounters—his obligation is to be useful. Nor did the ward rounds or the various weekly committees tire him. It was the paperwork on Friday afternoon that brought him down, the backlog of referrals, and responses to referrals, abstracts for two conferences, letters to colleagues and editors, an unfinished peer review, contributions to management initiatives, and government changes to the structure of the Trust, and yet more revisions to teaching practices. There’s to be a new look—there’s always a new look—at the hospital’s Emergency Plan. Simple train crashes are no longer all that are envisaged, and words like “catastrophe,” “mass fatalities,” “chemical and biological warfare,” and “major attack” have recently become bland through repetition. In the past year, he’s become aware of new committees and subcommittees spawning, and lines of command that stretch up and out of the hospital, beyond the medical hierarchies, up through the distant reaches of the Civil Service to the Home Secretary’s office.
Perowne dictated monotonously, and long after his secretary went home he sat typing in his overheated box of an office on the hospital’s third floor. What held him back was an unfamiliar lack of fluency. He prides himself on speed and a sleek, wry style. It never needs much forethought—composing and typing are one. Now he was stumbling. And though the professional jargon didn’t desert him—it’s second nature—his prose accumulated awkwardly. Individual words brought to mind unwieldy objects—bicycles, deck chairs, coat hangers—strewn across his path. He composed a sentence in his head, then lost it on the page, or typed himself into a grammatical cul-de-sac and had to sweat his way out. Whether this debility was the cause or the consequence of fatigue he didn’t pause to consider. He was stubborn and he pushed himself to the end. At eight in the evening, he concluded the last in a series of e-mails, and stood up from his desk, where he had been hunched since four. On his way out, he looked in at his patients in the I.C.U. There were no problems, and Andrea was doing fine—she was sleeping and all her signs were good.
Less than half an hour later, he came home to an empty house and lay in the bath with a book, content to be talking to no one. With one toe occasionally controlling a fresh input of hot water, he listened to the radio news. The stolid Mr. Blix had been addressing the U.N. again—there was a general impression that he had rather undermined the case for war. Afterward, Henry stretched out on the bed to consider his supper, and remembered nothing more. His wife, Rosalind, must have drawn the covers over him when she came in from work. She would have kissed him. Forty-eight years old, profoundly asleep at nine-thirty on a Friday night—this is modern professional life.
He crosses the bedroom and goes to the dressing room, to the corner where he stores his sports gear. These are the small pleasures at the start of a Saturday morning—the promise of coffee, and this faded squash kit. His daughter, Daisy, always a neat dresser, fondly calls it his scarecrow outfit. The blue shorts are bleached by patches of sweat that won’t wash out. Over a gray T-shirt, he puts on an old cashmere jumper with moth holes across the chest. Over the shorts, tracksuit pants, fastened with old cord at the waist. The white socks of prickly stretch towelling with yellow and pink bands at the top have something of the nursery about them. Unboxing them releases a homely aroma of the laundry. The squash shoes have a sharp smell, blending the synthetic with the animal, that reminds him of the court, the clean white walls and red lines, the unarguable rules of gladiatorial combat, and the score. It’s pointless pretending not to care about the score. He lost last week’s game against Jay Strauss, but as he crosses the room with cushioned, springy stride Henry feels he’ll win today. He opens the shutters, and the thought is instantly dispersed by the flood of low winter sunlight and by the sudden interest of what’s happening outside.
On the far side of the square, two Asian lads in tracksuits—he recognizes them from the newsagent’s on Warren Street—are unloading a van onto a handcart on the pavement. Placards are already piled high, and folded banners and cards of lapel buttons and whistles, football rattles and trumpets, funny hats and rubber masks of politicians—Bush and Blair in wobbling stacks, the topmost faces gazing blankly skyward, ghastly white in the sunshine. Gower Street, a few blocks away to the east, will be one of the starting points of the march, and some of the overspill has reached back here. A small crowd around the cart wants to buy stuff before the venders are ready. The general cheerfulness Perowne finds baffling. There are whole families, one with four children, in various sizes of bright-red coats, clearly under instructions to hold hands; and students, and a coachful of graying ladies in quilted anoraks and stout shoes. The Women’s Institute, perhaps. One of the tracksuited men holds up his hands in mock surrender; his friend standing on the back of the van makes his first sale. Displaced by the commotion, the square’s pigeons take off and wheel and dip in formation. Waiting for them below on a bench by a litter bin is a trembling red-faced man wrapped in a gray blanket with a sliced loaf ready on his lap. Among the Perowne children, “pigeon feeder” is a term synonymous with mentally deficient. Behind the throng around the cart is a bunch of kids in leather jackets and cropped hair, looking on with tolerant smiles. They have already unfurled their banner, which proclaims simply, “Peace Not Slogans!!”
The scene has an air of innocence and English dottiness. Perowne, dressed for combat on court, imagines himself as Saddam, surveying the crowd with satisfaction from some Baghdad ministry balcony: the good-hearted electorates of the Western democracies will never allow their governments to attack his country. But he’s wrong. The one thing Perowne thinks he knows about this war is that it’s going to happen. With or without the U.N. The troops are in place, they’ll have to fight. Ever since he treated an Iraqi professor of ancient history for an aneurysm, saw his torture scars and listened to his stories, Perowne has had ambivalent or confused and shifting ideas about this coming invasion. Miri Taleb is in his late sixties, a man of slight, almost girlish build, with a nervous laugh, a whinnying giggle that could have something to do with his time in prison. He did his Ph.D. at University College, London, and speaks excellent English. His field is Sumerian civilization, and for more than twenty years he taught at the university in Baghdad and was involved in various archeological surveys in the Euphrates area. His arrest came one winter afternoon in 1994, outside a lecture room where he was about to teach. His students were waiting for him inside and did not see what happened. Three men showed their security accreditations, and asked him to go with them to their car. There they handcuffed him, and it was at that point that his torture began. The cuffs were so tight that for sixteen hours, until they were removed, he could think of nothing but the pain. Permanent damage was done to both shoulders. For the following ten months, he was moved around central Iraq between various jails. He had no idea what these moves meant, and no means of letting his wife know he was still alive. Even on the day of his release, he didn’t discover what the charges were against him.
Perowne listened in his office to the Professor, and later talked to him in the ward after his operation—fortunately, a complete success. For a man approaching his seventieth birthday, Taleb had an unusual appearance: childlike smooth skin and long eyelashes, and a carefully groomed black mustache—surely dyed. In Iraq, he had no involvement or interest in politics, and declined to join the Baath Party. That may have been the cause of his problems. Equally, it could have been the fact that one of his wife’s cousins, long dead, was once a member of the Communist Party, or that another cousin had received a letter from Iran from a friend exiled because of his supposed Iranian descent; or that the husband of a niece had refused to return from a teaching job in Canada. Another possible reason was that the Professor himself had travelled to Turkey to advise on archeological digs. He was not particularly surprised by his arrest, and neither would his wife have been. They both knew, everyone knew, someone who’d been taken in, held for a while, tortured perhaps, and then released. People suddenly turned up at work again, and did not speak about their experiences, and no one dared ask—there were too many informers around, and inappropriate curiosity could get you arrested. Some came back in sealed coffins—it was strictly forbidden to open them. It was common to hear of friends and acquaintances making the rounds of the hospitals, police stations, and government offices hoping for news of their relatives.
Taleb spent his time in stinking, unventilated cells—six feet by ten with twenty-five men crammed inside. And who were these men? The Professor giggled mirthlessly. Not the expected combination of common criminals mixed in with intellectuals. They were mostly very ordinary people, held for not having a license plate on their car, or because they’d got into an argument with a man who turned out to be a Baath Party official, or because their children had been coaxed at school into reporting their parents’ unappreciative remarks at the dinner table about Saddam. Or because they refused to join the Party during one of the many recruitment drives. Another common crime was to have a family member accused of deserting from the Army.
Also in the cells were security officers and policemen. The various security services existed in a state of nervous competition with one another, and agents had to work harder and harder to show how diligent they were. Whole branches of security could come under suspicion. The torture was routine—Miri and his cellmates heard the screaming from their cells, and waited to be called. Beatings, electrocution, anal rape, near-drowning, thrashing the soles of the feet. Everyone, from top officials to street-sweepers, lived in a state of anxiety, constant fear. Henry saw the scars on Miri’s buttocks and thighs where he had been beaten with what he thought was a branch of some kind of thornbush. The men who beat him did so without hatred—only with routine vigor. They were scared of their supervisor, who was frightened for his own position, or his future liberty, because of an escape the year before.
“Everyone hates it,” Miri told Perowne. “You see, it’s only terror that holds the nation together. The whole system runs on fear, and no one knows how to stop it. Now the Americans are coming, perhaps for bad reasons. But Saddam and the Baathists will go. And then, my doctor friend, I will buy you a meal in a good Iraqi restaurant in London.”
Perowne takes his keys and phone and garage remote control from a silver dish by the recipe books. His wallet is in an overcoat hanging in a room behind the kitchen, outside the wine vaults. His squash racquet is upstairs on the ground floor, in a cupboard in the laundry. He puts on an old hiking fleece. As he steps outside and turns from closing the door, he hears the squeal of seagulls come inland for the city’s good pickings. The sun is low and only half of the square—his half—is in full sunlight. He walks away from the square along blinding moist pavement, surprised by the freshness of the day. The air tastes almost clean. He has an impression of striding along a natural surface, along some coastal wilderness, on a smooth slab of basalt causeway he vaguely recalls from a childhood holiday. It must be the cry of the gulls bringing it back. He can remember the taste of spray off a turbulent blue-green sea, and as he reaches Warren Street he reminds himself that he mustn’t forget to go to the fishmonger’s. Lifted by the coffee, and by movement at last, as well as the prospect of the game and the comfortable fit of the sheathed racquet in his hand, he increases his pace.
The streets around here are usually empty at weekends, but up ahead, along the Euston Road, a big crowd is making its way east toward Gower Street, and in the road itself, crawling in the eastbound lanes, are coaches nose-to-tail. The passengers are pressed against the glass, longing to be out there with the rest. They’ve hung their banners from the windows, along with football scarves and the names of towns from the heart of England—Stratford, Gloucester, Evesham. From the impatient pavement crowds, some dry runs with the noisemakers—a trombone, a squeeze-ball car horn, a Lambeg drum. There are ragged practice chants that at first he can’t make out. “Tumty-tumty-tum.” Don’t attack Iraq. Placards not yet on duty are held at a slope, at rakish angles over shoulders. “Not in My Name” goes past a dozen times. Its cloying self-regard suggests a bright new world of protest, with the fussy consumers of shampoos and soft drinks demanding to feel good, or nice. Henry prefers the languid “Down with This Sort of Thing.” A placard of one of the organizing groups goes by—the British Association of Muslims. Henry remembers that outfit well. It explained recently in its newspaper that apostasy from Islam was an offense punishable by death. Behind comes a banner proclaiming the Swaffham Women’s Choir, and then Jews Against the War.
On Warren Street, he turns right. Now his view is east, toward the Tottenham Court Road. Here’s an even bigger crowd, swelled by hundreds disgorging from the tube station. Backlit by the low sun, silhouetted figures break away and merge into a darker mass, but it’s still possible to see a makeshift bookstall and a hot-dog stand, cheekily set up on the corner right outside McDonald’s. It’s a surprise, the number of children there are, and babies in strollers. Despite his skepticism, Perowne, in white-soled trainers, gripping his racquet tighter, feels the seduction and excitement peculiar to such events: a crowd possessing the streets, tens of thousands of strangers converging with a single purpose conveying an intimation of revolutionary joy.
He might have been with them—in spirit at least, for nothing now will keep him from his game—if Professor Taleb hadn’t needed that aneurysm clipped on his middle cerebral artery. In the months after those conversations with the Professor, Perowne drifted into some compulsive reading up on the regime. He read about the inspirational example of Stalin, and the network of family and tribal loyalties that sustained Saddam, and the palaces handed out as rewards. Henry became acquainted with the details of genocides in the north and south of the country, the ethnic cleansing, the vast system of informers, the bizarre tortures and Saddam’s taste for getting personally involved, and the strange punishments passed into law—the brandings and amputations. Naturally, Henry followed closely the accounts of measures taken against surgeons who refused to carry out these mutilations. He concluded that viciousness had rarely been more inventive or systematic or widespread. Miri was right: it was indeed a republic of fear. Henry read Makiya’s famous book of that name. It was clear, Saddam’s organizing principle was terror.
Perowne knows that when a powerful imperium—Assyrian, Roman, American—makes war and claims just cause, history will not be impressed. He also worries that the invasion or the occupation will be a mess. The marchers could be right. And he acknowledges the accidental nature of opinions; if he hadn’t met and admired the Professor, he might have thought differently, less ambivalently, about the coming war. Opinions are a roll of the dice; by definition, none of the people now milling around the Warren Street tube station happen to have been tortured by the regime, or know and love anyone who has, or even know much about the place at all. It’s likely most of them barely registered the massacres in Kurdish Iraq, or in the Shiite south, and now they find they care with a passion for Iraqi lives. They have good reasons for their views, among which are concerns for their own safety. Al Qaeda, it’s said, which loathes both godless Saddam and the Shiite opposition, will be provoked by an attack on Iraq into revenge on the soft cities of the West. Self-interest is a decent enough cause, but Perowne can’t feel, as the marchers themselves probably can, that they have an exclusive hold on moral discernment.
He walks down a faint incline of greasy cobbles to where the owners of houses like his once kept their horses. Now those who can afford it cosset their cars here with off-street parking. Attached to his key ring is an infrared device that he presses to raise a clattering steel shutter. It’s revealed in mechanical jerks, the long nose and shining eyes at the stable door, chafing to be free. A silver Mercedes S500 with cream upholstery—and he’s no longer embarrassed by it. He doesn’t even love it—it’s simply a sensual part of what he regards as his overgenerous share of the world’s goods. If he didn’t own it, he tries to tell himself, someone else would. He hasn’t driven it in a week, but in the gloom of the dry dustless garage the machine breathes an animal warmth of its own. He opens the door and sits in. He likes driving it wearing his threadbare sports clothes. On the front passenger seat is an old copy of the Journal of Neurosurgery, which carries a report of his on a convention in Rome. He tosses his squash racquet on top of it. It’s his son, Theo, who disapproves most, calling it a doctor’s car, as if this were the final word in condemnation. Daisy, on the other hand, said she thought that Harold Pinter owned something like it, which made it all fine with her. Rosalind encouraged him to buy it. She thinks his life is too guiltily austere, and never buying clothes or good wine or a single painting is a touch pretentious. Still living like a graduate student. It was time for him to branch out.
For months, he drove it apologetically, rarely in fourth gear, reluctant to overtake, waving on right-turning traffic, punctilious in permitting cheaper cars their road space. He was cured at last by a fishing trip to northwest Scotland with Jay Strauss. Seduced by the open road and Jay’s exultant celebration of “Lutheran genius,” Henry finally accepted himself as the owner, the master of his vehicle. In fact, he’s always quietly considered himself a good driver: as in the operating theatre, firm, precise, defensive to the correct degree. He and Jay fished the streams and lochans around Torridon for brown trout. One wet afternoon, glancing over his shoulder while casting, Henry saw his car a hundred yards away, parked at an angle on a rise of the track, picked out in soft light against a backdrop of birch, flowering heather, and thunderous black sky—the realization of an adman’s vision—and felt for the first time a gentle, swooning joy of possession. It is, of course, possible, permissible, to love an inanimate object. But this moment was the peak of the affair; since then his feelings have settled into mild, occasional pleasure. The car gives him vague satisfaction when he’s driving it; the rest of the time it rarely crosses his mind. As its makers intended and promised, it’s become part of him.
But certain small things still stir him particularly, like the way the car idles without vibration; the rev counter alone confirms that the engine is turning. He switches on the radio, which is playing sustained, respectful applause as he eases out of the garage, and lets the steel shutter drop behind him, and goes slowly up the mews and turns left, back onto Warren Street. His squash club is on Huntley Street, in a converted nurses’ home—no distance at all, but he’s driving because he has errands to do afterward. Shamelessly, he always enjoys the city from inside his car, where the air is filtered and hi-fi music confers pathos on the humblest details—a Schubert string trio is dignifying the narrow street he’s slipping down now. He’s heading a couple of blocks south in order to loop eastward across the Tottenham Court Road. Cleveland Street used to be known for garment sweatshops and prostitutes. Now it has Greek, Turkish, and Italian restaurants—the local sort that never get mentioned in the guides—with terraces where people eat out in summer. There’s a man who repairs old computers, a fabric shop, a cobbler’s, and, farther down, a wig emporium, much visited by transvestites. This is the fair embodiment of an inner-city byway—diverse, selfconfident, obscure. Whenever he suffers a bout of insomnia, he easily persuades himself that the world has changed beyond recall, that harmless streets like this and the tolerant life they embody can be destroyed by the new enemy—well organized, tentacular, full of hatred and focussed zeal. How foolishly apocalyptic those apprehensions seem by daylight, when the self-evident fact of the streets and the people on them is its own justification, its own insurance. The world has not fundamentally changed. All this talk of a “hundred-year crisis” is mere indulgence. There are always crises, and Islamic terrorism will settle into place, alongside recent wars, climate change, the politics of international trade, shortages of land and fresh water, hunger, poverty, and the rest.
He listens to the Schubert sweetly fade and swell. The street is fine, and the city, grand achievement of the living and all the dead who’ve ever lived here, is fine, too, and robust. It won’t easily allow itself to be destroyed. It’s too good to let go. As he approaches the Tottenham Court Road, he sees a motorbike policeman in a yellow jacket, with his machine on its stand, holding out an arm to stop him. Of course, the road is closed for the march. He should have known. But still Perowne keeps coming, slowing all the while, as if, by pretending not to know, he could be exempted—after all, he only wants to cross this road, not drive down it. Or, at least, he’ll receive his due: a little drama of exchange between a firm but apologetic policeman and the solemnly tolerant citizen.
And, indeed, the cop is coming toward him, with a glance up the street at the marchers and a pursed, tolerant smile that suggests that he himself would have bombed Iraq long ago, and many other countries besides. Perowne, relaxed at the wheel, would have responded with a collegiate closed-mouth smile of his own, but two things happen, almost at the same time. Behind the patrolman, on the far side of the road, three men—two tall, in tracksuits, one thickset and short and wearing a black suit—are hurrying out of a lap-dancing club, the Spearmint Rhino, almost stumbling in their efforts not to run. When they turn the corner, onto the street Perowne wants to enter, they’re no longer so restrained. With the shorter man lagging behind, they run toward a car parked on the near side.
The second thing to happen is that the cop, meanwhile, unaware of the men, suddenly stops on his way to Perowne and raises a hand to his left ear. He nods and speaks into a microphone fixed in front of his mouth and turns toward his bike. Then, remembering what he was about, he glances back. Perowne meets his eye and, with a self-deprecating, interrogative look, points across the road at University Street. The cop shrugs, and then nods and makes a gesture with his hand to say, “Do it quickly, then.” What the hell. The marchers are still mostly up at the other end, and he’s received fresh orders.
Perowne isn’t late for his game, nor is he impatient to be across the road. He likes his car, but he’s never been interested in the details of its performance, its acceleration from a standing start. He assumes it’s impressive, but he’s never put it to the test. He’s far too old to be leaving rubber at traffic lights. As he slips into first, he looks diligently in both directions, even though it’s a one-way flow northward; he knows that pedestrians could be coming from either direction. If he moves briskly across the four-lane width of the road, it’s out of consideration for the policeman, who’s already starting up his bike. Perowne doesn’t want the man in trouble with his superiors. And that hand gesture communicated the need to be quick. By the time the Mercedes has travelled the sixty or seventy feet to the entrance of University Street, where he shifts into second, he may be doing twenty miles an hour. Twenty-five, perhaps. Thirty at a stretch. And even as he shifts up he’s easing off, looking out for the right turn before Gower Street, which is also closed off.
And the forward motion is a prompt: it instantly returns him to his thoughts. A second can be a long time in introspection. Long enough for Henry to think, or sense, without unwrapping the thought into syntax and words, that he was wrong: the marchers are there to remind him—the world probably has changed fundamentally, and the matter is being clumsily handled, particularly by the Americans. There are people around the planet, well connected and organized, who would like to kill him and his family and friends, just to make a point. The scale of death contemplated is no longer at issue; there’ll be more deaths on a similar scale, probably in this city. Is he so frightened that he can’t face the fact? The assertions and the questions don’t spell themselves out. He experiences them more as a mental shrug followed by an interrogative pulse. This is the preverbal language that linguists called mentalese. Hardly a language, more a matrix of shifting patterns, consolidating and compressing meaning in fractions of a second, and blending it inseparably with its distinctive emotional hue, which itself is rather like a color. A sickly yellow. Even with a poet’s gift of compression, it could take hundreds of words and many minutes to describe. So that when a flash of red streaks in across his left peripheral vision, like a shape on his retina in a bout of insomnia, it already has the quality of an idea, a new idea, unexpected and dangerous but entirely his, and not of the world beyond himself.
He’s driving with unconscious expertise into the narrow column of space framed on the right by a curb-flanked cycle path and on the left by a line of parked cars. It’s from this line that the thought springs, and, with it, the snap of a wing mirror cleanly sheared and the whine of sheet-steel surfaces sliding under pressure as two cars pour into a gap wide enough for one. Perowne’s instant decision at the moment of impact is to accelerate as he swerves right. There are other sounds—the staccato rattle of the red car on his left side raking a half-dozen stationary vehicles and the thwack of concrete against rubber, like an amplified single handclap, as the Mercedes mounts the cycle-path curb. His back wheel hits the curb, too. Then he’s ahead of the intruder and braking. The slewed cars stop thirty yards apart, engines cut, and for a moment there’s silence, and no one gets out.
By the standards of contemporary traffic accidents—Henry has done a total of five years in Accident and Emergency—this is a trivial matter. No one can possibly be hurt, and he won’t be in the role of doctor at the scene. He’s done it twice in the past five years, both for heart attacks, once on a flight to New York, another time in an airless London theatre during a June heat wave, both occasions unsatisfactory and complicated. He’s not in shock, he’s not weirdly calm or elated or numbed, his vision isn’t unusually sharp, he isn’t trembling. He listens to the click of hot metal contracting. What he feels is rising irritation struggling against worldly caution. He doesn’t have to look—one side of his car is wrecked. He already sees ahead into the weeks, the months of paperwork, insurance claims and counterclaims, phone calls, delays at the garage. Something original and pristine has been stolen from his car and can never be restored, however good the repair. There’s also the impact on the front axle, on the bearings, on those mysterious parts which conjure the essence of prolonged torture—rack and pinion. His car will never be the same again. It’s ruinously altered, and so is his Saturday. He’ll never make his game.
Above all, there swells in him a peculiarly modern emotion—the motorist’s rectitude, spot-welding a passion for justice to the thrill of hatred, in the service of which various worn phrases tumble through his thoughts, revitalized, cleansed of cliché: just pulled out, no signal, stupid bastard, didn’t even look, what’s his mirror for, fucking bastard. The only person in the world he hates is sitting in the car behind, and Henry is going to have to talk to him, confront him, exchange insurance details with him—all this when he could be playing squash. He feels he’s been left behind. And he seems to see it: receding obliviously down a side street is the other, most likely version of himself, like a vanishing rich uncle, introspective and happy, motoring carefree through his Saturday, leaving him alone and wretched, in his new, improbable, inescapable fate. This is real. Telling himself it is so betrays how little he believes it yet. He picks his racquet off the car floor and puts it back on top of the Journal. His right hand is on the door catch. But he doesn’t move yet. He’s looking in the mirror. There are reasons to be cautious.
There are, as he expected, three heads in the car behind. He knows he’s subject to unexamined assumptions, and he tries to examine them now. As far as he’s aware, lap dancing is a lawful pursuit. But if he’d seen the three men hurrying, even furtively, from the Wellcome Trust or the British Library he might already have stepped from his car. That they were running makes it possible they’ll be even more irritated than he is by the delay. The car is a 5 Series BMW, a vehicle he associates for no good reason with criminality, drug dealing. And there are three men, not one. The shortest is in the front passenger seat, and the door on that side is opening as he watches, followed immediately by the driver’s, and then the rear off-side door. Perowne, who does not intend to be trapped into talking from a sitting position, gets out of his car. The half minute’s pause has given the situation a gamelike quality in which calculations have already been made. The three men have their own reasons for holding back and discussing their next move. It’s important, Perowne thinks as he goes around to the front of his car, to remember that he’s in the right and that he’s angry. He also has to be careful. But these contradictory notions aren’t helpful, and he decides he’ll be better off feeling his way into the confrontation, rather than troubling himself with ground rules. His impulse then is to ignore the men, walk away from them, around the front of the Mercedes, to get a view of the damaged side. But even as he stands, with hands on hips, in a pose of proprietorial outrage, he keeps the men, now advancing as a group, on the edge of his vision.
At a glance, there seems to be no damage at all. The wing mirror is intact, there are no dents in the panels; amazingly, the metallic-silver paint is clean. He leans forward to catch the light at a different angle. With fingers splayed, he runs a hand lightly over the body, as if he really knows what he’s about. There is nothing. Not a blemish. In immediate, tactical terms, this seems to leave him at a disadvantage. He has nothing to show for his anger. If there’s any damage at all, it is out of sight, between the front wheels.
The men have stopped to look at something in the road. The short fellow in the black suit touches with the tip of his shoe the BMW’s shorn-off wing mirror, turning it over the way one might a dead animal. One of the others, a tall young man with the long mournful face of a horse, picks it up, cradling it in both hands. They stare down at it together and then, at a remark from the short man, they turn their faces toward Perowne simultaneously, with abrupt curiosity, like deer disturbed in a forest. For the first time, it occurs to him that he might be in some kind of danger. Officially closed off at both ends, the street is completely deserted. Behind the men, on the Tottenham Court Road, a broken file of protesters is making its way south to join the main body. Perowne glances over his shoulder. There, behind him on Gower Street, the march proper has begun. Thousands packed in a single dense column are making for Parliament Square, their banners angled forward heroically, as in a revolutionary poster. From their faces, hands, and clothes they emanate the rich color, almost like warmth, peculiar to compacted humanity. For dramatic effect, they’re walking in silence to the funereal beat of marching drums.
The three men resume their approach. As before, the short man—five feet five or six, perhaps—is out in front. His gait is distinctive, with a little jazzy twist and dip of his trunk, as though he were punting along a gentle stretch of river. The punter from the Spearmint Rhino. Perhaps he’s listening to his headphones. Some people go nowhere, even into disputes, without a soundtrack. The other two have the manner of subordinates, sidekicks. They’re wearing trainers, tracksuits, and hooded sweatshirts—the currency of the street, so general as to be no style at all. Theo sometimes dresses this way, in order, so he says, not to make decisions about how he looks. The horse-faced fellow is still holding the wing mirror in both hands, presumably to make a point. The unrelenting throb of drums is not helpful to the situation, and the fact that so many people are close by, unaware of him, makes Henry feel all the more isolated. It’s best to go on looking busy. He drops down closer to the car, noting a squashed Coke can under his front tire. There is, he sees now, with both relief and irritation, an irregular patch on the rear door where the sheen is diminished, as though rubbed with a fine emery cloth. Surely the contact point, confined to a two-foot patch. How right he was, swerving away before he hit the brake. He feels steadier now, straightening up to face the men as they stop in front of him.
Unlike some of his colleagues—the surgical psychopaths—Henry doesn’t actually relish personal confrontation. He isn’t the machete-wielding type. But clinical experience is, among all else, an abrasive, toughening process, bound to wear away at one’s sensitivities. Patients, juniors, the recently bereaved, management, of course—inevitably, in two decades, the moments have come around when he’s been required to fight his corner, or explain, or placate in the face of a furious emotional upsurge. There’s usually a lot at stake: for colleagues, questions of hierarchy and professional pride or wasted hospital resources, for patients a loss of function, for their relatives a suddenly dead spouse or child—weightier affairs than a scratched car. Especially when they involve patients, these moments have a purity and innocence about them; everything is stripped down to the essentials of being—memory, vision, the ability to recognize faces, chronic pain, motor function, even a sense of self. What lies in the background, glowing faintly, are the issues of medical science, the wonders it performs, the faith it inspires, and, against that, its slowly diminishing but still vast ignorance of the brain, and the mind, and the relation between the two. Regularly penetrating the skull with some modest success is a relatively recent adventure. There’s bound to be disappointment sometimes, and when it comes, the showdown with the relatives in his office, no one needs to calculate how to behave or what to say, no one feels watched. It pours out.
Among Perowne’s acquaintance are those medics who deal not with the brain but only with the mind, with the diseases of consciousness; these colleagues embrace a tradition, a set of prejudices only rarely voiced nowadays, that the neurosurgeons are blundering arrogant fools with blunt instruments, bonesetters let loose upon the most complex object in the known universe. When an operation fails, the patient or the relatives tend to come around to this view. But too late. What is said then is tragic and sincere. However appalling these heartfelt engagements, however much he knows himself to be maligned by a patient’s poor or self-serving recollection of how the risks were outlined, whatever his certainty that he’s performed in the theatre as well as current knowledge and techniques allow, Perowne comes away not only chastened—he has manifestly failed to lower expectations—but obscurely purified: he’s had a fundamental human exchange, as elemental in its way as love.
But here on University Street it’s impossible not to feel that playacting is about to begin. Dressed like a scarecrow, in mangy fleece, his sweater with its row of holes, his paint-stained trousers supported by a knotted cord, he stands by his powerful machine. He is cast in a role, and there’s no way out. This, as people like to say, is urban drama. A century of movies and half a century of television have rendered the matter insincere. It is pure artifice. Here are the cars, and here are the owners. Here are the guys, the strangers, whose self-respect is on the line. Someone is going to have to impose his will and win, and the other is going to give way. Popular culture has worn this matter smooth with reiteration, this ancient genetic patrimony that also oils the machinations of bullfrogs and cockerels and stags. And, despite the varied and casual dress code, there are rules as elaborate as the politesse of the Versailles court which no set of genes can express. For a start, it is not permitted as they stand there to acknowledge the self-consciousness of the event, or its overbearing irony: from just up the street, they can hear the tramping and tribal drums of the peacemongers. Furthermore, nothing can be predicted, but everything, as soon as it happens, will seem to fit.
“Cigarette?”
Exactly so. This is how it’s bound to start.
In an old-fashioned gesture, the other driver offers the pack with a snap of the wrist, arranging the unfiltered cigarettes like organ pipes. The gripped hand extending toward Perowne is large, given the man’s height, and papery pale, with black hair coiled on the back and extending to the distal interphalangeal joints. The persistent tremor also draws Perowne’s professional attention. Perhaps there’s reassurance to be had in the unsteadiness of the grip.
“I won’t, thanks.”
He lights one for himself and blows the smoke past Henry, who’s already one point down—not man enough to smoke, or, more essentially, to offer gifts. It’s important not to be passive. It has to be his move. He puts out his own hand.
“Henry Perowne.”
“Baxter.”
“Mr. Baxter?”
“Baxter.”
Baxter’s hand is large, Henry’s fractionally larger, but neither man attempts a show of strength. Their handshake is light and brief. Baxter is one of those smokers whose pores exude a perfume, an oily essence of his habit. Garlic affects certain people the same way. Possibly the kidneys are implicated. He’s a fidgety, small-faced young man with thick eyebrows and dark-brown hair razored close to the skull. The mouth is set bulbously, with the smoothly shaved shadow of a strong beard adding to the effect of a muzzle. The general simian air is compounded by sloping shoulders, and the built-up trapezoids suggest time in the gym, compensating for his height, perhaps. The sixties-style suit—tight cut, high lapels, flat-fronted trousers worn from the hip—is taking some strain around the jacket’s single fastened button. There’s also tightness in the fabric around the biceps. He half turns and dips away from Perowne, then bobs back. He gives an impression of fretful impatience, of destructive energy waiting to be released. He may be about to lash out. Perowne is familiar with some of the current literature on violence. It’s not always a pathology; self-interested social organisms find it rational to be violent sometimes. Among the game theorists and radical criminologists, the stock of Thomas Hobbes keeps on rising. Holding the unruly, the thugs, in check is the famous “common power” to keep all men in awe—a governing body, an arm of the state, freely granted a monopoly on the legitimate use of violence. But drug dealers and pimps, among others who live beyond the law, are not inclined to dial 999 for Leviathan; they settle their quarrels in their own way.
Perowne, almost a foot taller than Baxter, considers that if it comes to a scrap he’ll be wise to protect his testicles. But it’s a ridiculous thought; he hasn’t been in a hand-to-hand fight since he was eight. Three against one. He simply won’t let it happen.
Baxter says as soon as they’ve shaken hands, “I expect you’re all ready to tell me how sincerely sorry you are.” He looks back, past the Mercedes, to his own car where it’s parked at a diagonal across the road. Behind it is an irregular line scraped along the sides of half a dozen parked cars by the BMW’s door handle. The appearance on the street now of just one outraged owner will be enough to set off a cascade of insurance claims. Henry, knowing a good deal about paperwork, can already sense the prolonged trauma of it. Far better to be one of many victims than the original sinner.
He says, “I am indeed sorry that you pulled out without looking.”
He surprises himself. This fussy, faintly archaic “indeed” is not generally part of his lexicon. Deploying it entails decisions; he isn’t going to pretend to the language of the street. He’s standing on professional dignity.
Baxter lays his left hand on his right, as though to calm it. He says patiently, “I didn’t need to be looking, did I? The Tottenham Court Road’s closed. You weren’t supposed to be there.”
Perowne says, “The rules of the road aren’t suspended. Anyway, a policeman waved me across.”
“Police man?” Baxter’s dividing and leaning on the construction makes it sound childish. He turns to his friends. “You seen a police man?” And then back to Perowne, with mocking politeness: “This is Nark, and this is Nigel.”
Until now, the two have stood off to one side, just behind Baxter, listening without expression. Nigel is the horse-faced man. His companion may be a police informer, or addicted to narcotics, or, given his comatose look, presenting with narcolepsy.
“No policemen round here,” Nigel explains. “They all busy with the marching scum.”
Perowne pretends to ignore both men. His business is with Baxter. “This is the moment we swap insurance details.” All three chuckle at this, but he continues: “If we can’t agree on what happened, we’ll phone the police.” He looks at his watch. Jay Strauss will be on court, warming up the ball. It’s not too late to settle the matter and get on his way. Baxter hasn’t reacted to the mention of a phone call. Instead, he takes the wing mirror from Nigel and displays it to Perowne. The spiderweb fissures in the glass show the sky in a mosaic of white and ragged blue which shimmers with the agitation in Baxter’s hand. His tone is genial.
“Fortunately for you, I got a mate does bodywork, on the cheap. But he does a nice job. Seven-fifty I reckon he’d sort me out.”
Nark rouses himself. “There’s a cash point on the corner.”
And Nigel, as though pleasantly surprised by the idea, says, “Yeah. We could walk down there with you.”
These two have shifted their position so they’re almost, but not quite, flanking Henry. Baxter, meanwhile, steps back. The maneuverings are clumsily deliberate, like an ill-rehearsed children’s ballet. Perowne’s attention, his professional regard, settles once again on Baxter’s right hand. It isn’t simply a tremor; it’s a fidgety restlessness implicating practically every muscle. Speculating about it soothes him, even as he feels the shoulders of both men pressing lightly through his fleece. Perversely, he no longer believes himself to be in any great danger. It’s hard to take the trio seriously; the cash idea has a boyish, make-believe quality. Everything said seems like a quotation from something they’ve all seen a dozen times before and half forgotten.
At the sound of a trumpet expertly played, the four men turn to watch the march. It’s a series of intricate staccato runs that end on a high tapering note. It might be a passage from a Bach cantata, because Henry immediately imagines a soprano and a sweetly melancholic air, and, in the background, a supportive cello squarely sawing away. On Gower Street, the concept of a reproachful funereal march no longer holds. It was difficult to sustain with thousands in a column stretching over hundreds of yards. Now the chants and clapping rise and fall in volume as different sections of the crowd move past the junction with University Street. Baxter’s fixed regard is on it as it passes, his features faintly distorted, strained by pity. A textbook phrase comes to Henry in much the same way as the cantata melody—a modest rise in his adrenaline level is making him unusually associative. Or the pressures of the past week won’t release him from the habits, the intellectual game of diagnosis. The phrase is “a false sense of superiority.” Yes, it can be put down to a slight alteration in character, preceding the first tremors, somewhat short of, a little less disabling than, those other neurological conditions—grandiosity, delusions of grandeur. But he may be misremembering. Neurology is not his field. As Baxter stares at the marchers, he makes tiny movements with his head, little nods and shakes. Watching him unobserved for a few seconds, Perowne suddenly understands: Baxter is unable to initiate or make saccades—those flickering changes of eye position from one fixation to another. To scan the crowd, he is having to move his head.
As though in confirmation, he turns his whole body toward Perowne and says genially, “Horrible rabble. Sponging off the country they hate.”
Perowne thinks he understands enough about Baxter to know he should get clear. Shrugging off Nigel and Nark at his side, he turns toward his car. “I’m not giving you cash,” he says dismissively. “I’m giving you my details. If you don’t want to give me yours, that’s fine. Your registration number will do. I’ll be on my way.” He then adds, barely truthfully, “I’m late for an important meeting.”
But most of this sentence is obliterated by a single sound, a shout of rage.
Even as he turns back toward Baxter in surprise, and even as he sees, or senses, what’s coming toward him at such speed, there remains in a portion of his thoughts a droning, pedestrian diagnostician who notes poor self-control, emotional lability, explosive temper, suggestive of reduced levels of gaba and excessive glutamate among the appropriate binding sites on striatal neurons. There is much in human affairs that can be accounted for at the level of the complex molecule. Who could ever reckon up the damage done to love and friendship and all hopes of happiness by a surfeit or depletion of this or that neurotransmitter? And who will ever find a morality, an ethics down among the enzymes and amino acids, when the general taste is for looking in the other direction?
Despite Baxter’s impaired ocular fixation, and his chorea, those quick, jerky movements, the blow that’s aimed at Perowne’s heart and that he dodges only fractionally lands on his sternum with colossal force, so that it seems to him, and perhaps it really is the case, that there surges throughout his body a sharp ridge, a shock wave, of high blood pressure, a concussive thrill that carries with it not so much pain as an electric jolt of stupefaction and a brief deathly chill that has a visual component of blinding, snowy whiteness.
“All right,” he hears Baxter say, which is an instruction to his companions.
They grab Henry by his elbows and forearms, and as his vision clears he sees that he’s being propelled through a gap between two parked cars. Together, they cross the pavement at speed. They turn him and slam his back against a chain-locked double door in a recess. He sees on the wall to his left a polished brass plaque that says “Fire Exit, Spearmint Rhino.” Just up the street is a pub, the Jeremy Bentham. But, if it’s open this early, the drinkers are all inside in the warmth. Perowne has two immediate priorities whose importance holds as his full consciousness returns. The first is to keep the promise to himself not to fight back. The punch has already told him how much expertise he lacks. The second is to stay on his feet. He’s seen a fair number of brain injuries among those unlucky enough to fall to the ground before their attackers. The foot, like some roughneck hick town, is a remote province of the brain, liberated by distance from responsibility. A kick is less intimate, less involving, than a punch, and one kick never quite seems enough. Back in the epic days of organized football violence when he was a registrar, he learned a good deal about subdural hematomas from steel-tipped Doc Martens.
He stands facing them in a little whitewashed brick cave of a recess, well out of sight of the march. The structure amplifies the rasp of their breathing. Nigel takes a fistful of Perowne’s fleece and with the other hand seeks out the bulge of his wallet, which is in an inside zipped pocket.
“Nah,” Baxter says. “We don’t want his money.”
By this Perowne understands that honor is to be satisfied by a thorough beating. As with the insurance claims, he sees the dreary future ahead. Weeks of painful convalescence. Perhaps that’s optimistic. Baxter’s gaze is on him, a gaze that can’t be shifted unless he moves the whole of his heavy shaven head. His face is alive with small tremors that never quite form into an expression. It is a muscular restlessness that will one day—this is Perowne’s considered opinion—become athetoid, plagued by involuntary, uncontrollable movements.
There’s a sense among the trio of a pause for breath, a steadying before the business. Nark is already bunching his right fist. Perowne notes three rings on the index, middle, and ring fingers, bands of gold as broad as sawn-off plumbing. He has, he reckons, a few seconds left. Baxter is in his mid-twenties. This isn’t the moment to be asking for a family history. If a parent has it, you have a fifty-fifty chance of going down, too. Chromosome 4. The misfortune lies within a single gene, in an excessive repeat of a single sequence—CAG. Here’s biological determinism in its purest form. More than forty repeats of that one little codon and you’re doomed. Your future is fixed and easily foretold. The longer the repeat, the earlier the onset. Between ten and twenty years to complete the course, from the first small alterations of character, twitches in the hands and face, emotional disturbance, including—most notably—sudden, uncontrollable alterations of mood, to the helpless jerky dance-like movements, intellectual dilapidation, memory failure, agnosia, apraxia, dementia, total loss of muscular control, rigidity sometimes, nightmarish hallucinations, and a meaningless end. This is how the brilliant machinery of being is undone by the tiniest of faulty cogs, the insidious whisper of ruin, a single bad idea lodged in every cell, on every chromosome 4.
Nark is drawing back his right arm to strike. Nigel seems content to let him go first. Henry has heard that early onset tends to indict the paternal gene. But that may not be right. There’s nothing to lose by making a guess. He speaks into the blaze of Baxter’s regard.
“Your father had it. Now you’ve got it, too.”
He has the impression of himself as a witch doctor delivering a curse. Baxter’s expression is hard to judge. He makes a vague, febrile movement with his left hand to restrain his companions. There’s silence as he swallows and strains forward, frowning, as if about to clear an obstruction from his throat. Perowne has expressed himself ambiguously. His “had” could easily have been taken for a “has.” And Baxter’s father, alive or dead, might not even be known to his son. But Perowne is counting on Baxter’s knowing about his condition. If he does, he won’t have told Nigel or Nark or any of his friends. This is his secret shame. He may be in denial, knowing and not knowing, knowing and preferring not to think about it.
When Baxter speaks at last, his voice is different, cautious perhaps. “You knew my father.”
“I’m a doctor.”
“Like fuck you are, dressed like that.”
“I’m a doctor. Has someone explained to you what’s going to happen? Do you want me to tell you what I think your problem might be?”
It works, the shameless blackmail works. Baxter flares suddenly. “What problem?” And before Perowne can reply he adds ferociously, “And you’ll shut the fuck up.” Then, as quickly, he subsides and turns away. They are together, he and Perowne, in a world not of the medical but of the magical. When you’re diseased, it is unwise to abuse the shaman.
Nigel says, “What’s going on? What did your dad have?”
“Shut up.”
The moment of the thrashing is passing and Perowne senses the power passing to him. This fire-escape recess is his consulting room. Its mean volume reflects back to him a voice regaining the full timbre of its authority. He says, “Are you seeing someone about it?”
“What’s he on about, Baxter?”
Baxter shoves the broken wing mirror into Nark’s hands. “Go and wait in the car.”
“You’re kidding.”
“I mean it. Both of you. Go and wait in the fucking car.”
It is pitifully evident, Baxter’s desperation to separate his friends from the sharer of his secret. The two young men exchange a look and shrug. Then, without a glance at Perowne, they set off back up the road. Hard to imagine they don’t think something is wrong with Baxter. But these are the early stages of the disease, and its advance is slow. They might not have known him long. And a jazzy walk, an interesting tremor, the occasional lordly flash of temper or mood swing might in their milieu mark out a man of character. When they reach the BMW, Nark opens a rear door and tosses the wing mirror in. Side by side, they lean on the front of the car, arms folded, like movie hoods, watching Baxter and Perowne.
Perowne persists gently. “When did your father die?”
“Leave it.”
Baxter is not looking at him. He stands fidgeting with shoulder turned, like a sulky child waiting to be coaxed, unable to make the first move. Here is the signature of so many neurodegenerative diseases—the swift transition from one mood to another, without awareness or memory, or understanding of how it seems to others.
“Is your mother still alive?”
“Not as far as I’m concerned.”
“Are you married?”
“No.”
“Is your real name Baxter?”
“That’s my business.”
“All right. Where are you from?”
“I grew up in Folkestone.”
“And where do you live now?”
“My dad’s old flat. Kentish Town.”
“Any occupation, training, college?”
“I didn’t get on with school. What’s that to do with you?”
“And what’s your doctor said about your condition?”
Baxter shrugs. But he’s accepted Perowne’s right to interrogate. They’ve slipped into their roles, and Perowne keeps going.
“Has anyone mentioned Huntington’s disease to you?”
A feeble dry rattling sound, like that of stones shaken in a tin, reaches them from the march. Baxter is looking at the ground. Perowne takes his silence as confirmation.
“Do you want to tell me who your doctor is?”
“Why would I do that?”
“We could get you referred to a colleague of mine. He’s good. He could make things easier for you.”
At this, Baxter turns and angles his head in his attempt to settle the taller man’s image on his fovea, that small depression on the retina where vision is most acute. There’s nothing anyone can do about a damaged saccadic system. And, generally, there’s nothing on offer at all for this condition, beyond managing the descent. But Henry sees now in Baxter’s agitated features a sudden avidity, a hunger for information, or hope. Or simply a need to talk.
“What sort of thing?”
“Exercises. Certain drugs.”
“Exercise . . .” He snorts on the word. He is right to pick up on the fatuity, the feebleness of the idea. Perowne presses on.
“What has your doctor told you?”
“He said there’s nothing, didn’t he.”
He says this as a challenge, or a calling in of a debt; Perowne’s been reprieved, and in return he has to come up with a reason for optimism, if not a cure. Baxter wants his doctor proved wrong.
But Perowne says, “I think he’s right. There was some work with stem-cell implantation in the late nineties, but . . .”
“It was shit.”
“Yes, it was disappointing. Best hope now, apparently, is RNA interference.”
“Yeah. Gene silencing. One day, perhaps. After I’m dead.”
“You’re well up on this, then.”
“Oh, thank you, Doctor. But what’s this about certain drugs?”
Perowne is familiar with this impulse in patients, this pursuit of the slenderest leads. If there’s a drug, Baxter or his doctor will know about it. But it’s necessary for Baxter to check. And check again. Someone might know something he doesn’t. A week passes and there could be a new development. And when the line runs out in this field the charlatans lie in wait for the fearful, offering the apricot-stone diet, the aura massage, the power of prayer. Over Baxter’s shoulder Perowne can see Nigel and Nark. They’re no longer leaning against the car but walking up and down in front of it, talking animatedly, gesturing up the road.
Perowne says, “I’m talking about pain relief, help with loss of balance, tremors, depression.”
Baxter moves his head from side to side. The muscles in his cheeks are independently alive. Henry senses an approaching shift of mood. “Oh, fuck,” Baxter keeps murmuring to himself. “Oh, fuck.” In this transitional phase of perplexity or sorrow, the vaguely apelike features are softened, even attractive. He’s an intelligent man, and gives the impression that, illness apart, he’s missed his chances, made some big mistakes and ended up in the wrong company. Probably dropped out of school long ago and regrets it. No parents around. And now, what worse situation than this could he find himself in? There’s no way out for him. No one can help. But Perowne knows himself to be incapable of pity. Clinical experience wrung that from him long ago. And a part of him never ceases to calculate how soon he can safely end this encounter. Besides, the matter is beyond pity. There are so many ways a brain can let you down. Like an expensive car, it’s intricate, but mass-produced nevertheless, with more than six billion in circulation.
Rightly, Baxter believes he’s been cheated of a little violence and the exercise of a little power, and the more he considers it the angrier he becomes. Another rapid change in mental weather, a new mood front is approaching, and it’s turbulent. He ceases his murmuring and moves in close enough for Perowne to smell a metallic flavor on his breath.
“You streak of piss,” Baxter says quickly as he pushes him in the chest. “You’re trying to fuck with me. In front of those two. You think I care? Well, fuck you. I’m calling them back.”
From his position, with his back to the fire exit, Perowne can already see that a bad moment awaits Baxter. He turns away from Perowne and steps out into the center of the pavement in time to see Nigel and Nark walking away from the BMW, back toward the Tottenham Court Road.
Baxter makes a short run in their direction and shouts, “Oi!”
They glance back, and Nark, uncharacteristically energetic, gives him the finger. As they walk on, Nigel makes a limp-wristed dismissive gesture. The general has been indecisive, the troops are deserting, the humiliation is complete. Perowne, too, sees his opportunity to withdraw. He crosses the pavement, steps into the road and around his car. His keys are in the ignition. As he starts the engine, he sees Baxter in his rearview mirror, dithering between the departing factions, shouting at both. Perowne eases forward—for pride’s sake, he does not want to appear hurried. The insurance is an irrelevance, and it amazes him now that he ever thought it important. He sees his racquet on the front seat beside him. This is surely the moment to slip away, while the possibility remains that he can still rescue his game. 
